State-of-the-Art Review of Current Technology in Pressure Injury Early Detection.
Yi-Ting Tzen, Barbara Delmore, Kath M Bogie and 9 others
PMID 41085249WHAT IT FOUND
Four FDA-cleared or authorized devices add nonvisible pressure injury signs to skin checks: ultrasound, thermal imaging, subepidermal moisture, and tissue oxygenation.
They are adjuncts, not replacements, and evidence is limited.
Key findings
01Four clinical device categories are FDA-cleared or authorized for related indications: ultrasonography, long-wave infrared thermography, subepidermal moisture measurement, and near-infrared spectroscopy.
02Subepidermal moisture is intended as an adjunct to standard care for heels and sacrum in high-risk patients, and a SEM difference of 0.6 or more suggests localized edema under intact skin.
03The review says these devices may help detect early injury in dark skin tones, but their detection performance is not fully studied.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review is a technology overview. It is not a trial that shows any device improves patient outcomes or prevents pressure injuries. The device list was finalized by expert consensus after a PubMed search, so it may not represent a complete systematic comparison of all available products. The paper states that device use for pressure injury detection is not fully studied, and reported accuracy is limited to certain stages, locations, and populations. There is no standard method to compare the devices, and no phantom adequately simulates all relevant tissue parameters. Research devices are not validated or approved for clinical implementation, and blood-flow devices use arbitrary units that are hard to compare. Ultrasonography requires radiology infrastructure and licensed or certified personnel, so it may not be practical in skilled nursing or long-term care. Billing is limited: no CPT code exists for pressure injury early detection, and some codes may not be reimbursed by all payers. A single critical care report of a 100% reduction in hospital-acquired pressure injury incidence in 50 patients is too small to prove effectiveness. Devices are adjuncts and do not replace visual inspection and palpation.
The easy way to misread this
Do not conclude that these devices have been proven to prevent pressure injuries or that they can replace skin assessment. The review calls them adjuncts, says the detection application is not fully studied, and notes there is no standard to compare device performance.